Chest case 2007

33yo / male
Dyspnea for three days

He was known to be HIV-positive

 Chest radiograph shows hazy areas of

increased lung density throughout the lungs.
Multiple thin-walled air-containing structures are
identified in both upper lung zones.
HRCT scans show areas of ground glass
attenuation, within which both thin-walled and
thick-walled and cystic lesions are identified in
both upper lobes.

 68 / F
Chief complaint
Mild fever and dyspnea for two days.
Three months ago, she had been diagnosed as
having a central lung cancer in left lower lobe with
metastases to lower paraesophageal lymph nodes
and brain.
Radiation therapy was performed in the regional lung
lesion including lower paraesophageal lymph nodes
with posteroanterior direction.

41 / male

Chief complaint

Cough and dyspnea for six

months.
He was known to be HIVpositive and a CD4 level was 4
cells/ mm3.
He had small, raised reddishpurple nodules on the skin.

Chest radiograph shows nodular and linear infiltrates with a perihilar and basal
distribution. There are bilateral small pleural effusions.
HRCT scan shows bilateral nodular or flame-shaped lesions along
bronchovascular bundles. CT scan viewed at mediastinal windows shows bilateral
pleural effusions and enlargement of subcarinal lymph node
Kaposi's sarcoma (autopsy-proven)

39 / female
Chief complaint

cough and sputum for one

month

Primary lung cancer (adenocarcinoma) in RLL

with miliary metastasis and pericardial seeding

Chest PA shows innumerable multiple tiny nodules uniformly distributed

throughout both lungs.
Chest lateral shows suspicious ovoid opacity in lower lung zone.
HRCT shows numerous miliary nodules in diffuse and random distribution in
both lungs.
Some linear densities are noted in peripheral portion suggesting interlobular
and intralobular septal thickening.
Irregular spiculated ovoid mass is noted in RLL.
Moderate amount of pericardial effusion is noted

Pneumocystis carinii pneumonia. Bilateral interstitial infiltrates.

 confirming the presence of thoracic pathology in

symptomatic AIDS patients;
differential diagnosis;
advising on and performing thoracic
interventions such as biopsy or chest drainage;
monitoring the response to therapy following
diagnosis.

Adult male HIV-positive patient with a community-acquired staphylococcal

pneumonia. The chest radiograph shows a right upper lobe pulmonary
consolidation with central cavitation.

36-year-old male HIV-positive patient with recurrent bronchitis. Thin section CT

demonstrates extensive segmental and subsegmental bronchiectasis(straight
arrows) with diffuse air trapping and several centrilobular nodules due to
plugging of small airways (curved arrow).

39-year-old AIDS patient with endobronchial spread of pulmonary tuberculosis

diagnosed on sputum culture. Thin section CT demonstrates multiple thickwalled cavities (straight arrow) and a "tree in bud" appearance due to plugging
of small airways (curved arrow).

avian influenza

sars

sars